Evaluation of Peroperative Fluid Balance with PVI (Pleth Variability Index) and Correlation with NIRS (Near Infrared Spectroscopy)

Yıl 2024, , 115 - 123, 23.09.2024

Cana Melis Çelik Sermin Altunbaş , Yücel Karaman

https://doi.org/10.57221/izmirtip.1494247

Öz

Abstract

Aim: The aim of this study was to evaluate the fluid therapy given in major abdominal surgeries with PVI (pleth variability index) and to monitor its correlation with NIRS (cerebral oximetry).

Materials and methods: In this prospective, observational study, 86 patients with ASA physical status score I-II-III and undergoing major abdominal surgery were included. All patients underwent cerebral oximetry (right-left cerebral oxygen saturation by near-infrared spectroscopy) and PVI (pleth variability index) monitoring before anesthesia in addition to standard ASA monitoring. Patients who underwent arterial cannulation were included in the study. Demographic and hemodynamic data, right/left cerebral oxygen saturation values and PVI values were recorded at baseline before induction, 5 minutes after induction, 1, 2, 3, 4, 5 hours and at the end of surgery.

Results: In our study, right and left cerebral oxygen saturation was correlated with hemoglobin, etCO2 and pCO2. Similar correlation was found between etCO2 and PVI, but PVI was not correlated with hemoglobin. PVI was correlated with systolic arterial pressure and basal right cerebral oxygen saturation.

Conclution: We concluded that evaluation of fluid therapy by PVI in major abdominal surgeries is affected by factors such as hypothermia, vascular tone and measurement site. Cerebral oxygen saturation was correlated with hemoglobin, etCO2 and pCO2 values, which is consistent with the literature. No statistical correlation was found between PVI and NIRS

Keywords: Near-infrared spectroscopy; pleth variability index; major abdominal surgery

Anahtar Kelimeler

Near-infrared spectroscopy, pleth variability index, major abdominal surgery

Peroperatif Sıvı Dengesinin PVI (Pleth Variability Index) ile Değerlendirilmesi ve NIRS (Near Infrared Spectroscopy) ile Korelasyonu

Öz

Amaç: Bu çalışmada; majör abdominal cerrahilerde verilen sıvı tedavisinin PVI (pleth variability indeks) ile değerlendirilmesi ve NIRS (serebral oksimetre) ile korelasyonunun izlenmesi amaçlandı.

Gereç ve yöntemler: Prospektif, gözlemsel olarak tasarlanan bu çalışmaya, majör abdominal cerrahi geçirecek ASA fiziksel durum skoru I-II-III olan 86 hasta dahil edildi. Tüm olgulara anestezi öncesi standart ASA monitörizasyonuna ek olarak serebral oksimetri (yakın-kızıl ötesi spektroskopi ile sağ-sol serebral oksijen satürasyonu) ve PVI (pleth variability indeks) monitörizasyonu yapıldı. Arteriyel kanülasyon yapılmış olan hastalar çalışmaya dahil edildi. Hastaların demografik ve hemodinamik verileri, sağ/sol serebral oksijen satürasyon değerleri ve PVI değerleri indüksiyon öncesi bazal, indüksiyon sonrası 5. dakika , 1., 2.,3.,4., 5. saat ve cerrahi bitiminde kayıt altına alındı.

Bulgular: Çalışmamızda sağ ve sol serebral oksijen satürasyonun hemoglobin, etCO2 ve pCO2 ile korele olduğu saptandı. Benzer korelasyonun etCO2 ve PVI arasında da olduğu Ancak PVI değerinin hemoglobin ile korelasyonunun olmadığı saptandı. PVI’nin sistolik arterial basınç ve bazal sağ serebral oksijen satürasyonu ile korelasyonu saptandı.

Sonuç: Majör abdominal cerrahilerde, sıvı tedavisinin PVI ile değerlendirilmesinin hipotermi, vasküler tonus, ölçüm yeri gibi faktörlerden etkilendiği sonucuna vardık. Serebral oksijen satürasyonu literatürle uyumlu olacak şekilde, hemoglobin, etCO2 ve pCO2 değerleri ile korelasyon göstermiştir. PVI ile NIRS arasında da istatistiksel bir korelasyon saptanmamıştır.

Anahtar kelimeler: Yakın-kızıl ötesi spektroskopi; majör abdominal cerrahi; Dalga değişkenlik indeksi

Anahtar Kelimeler

Yakın-kızılötesi spektroskopi, majör abdominal cerrahi, dalga değişkenlik indeksi

Kaynakça

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